***SHORT TERM COVID MANAGEMENT PLAN FOR CAHC**
12/29/21 We fully appreciate that our patients need to obtain testing for COVID-19 for your children who are having symptoms, who have been exposed to others with COVID-19 and who require testing to return to school. We are experiencing incredible numbers of requests while also seeing patients and managing our usual office schedule. We have very limited access to testing in our office and our supplies are allocated from the hospital which is in short supply. We are happy to order testing for your children through the hospital system but have so many requests that we will be bundling our orders to twice a day. If your child requires a test, please call the office and leave your message with the following information: your child's name and date of birth, the reason for the test (exposure, including the first and last date of exposure vs. symptoms vs. travel vs. return to school) We will input the test requests in the order in which they are received but will be doing this only twice a day as we need our clinical time to care for patients. Please understand that the testing centers are full and your test may be scheduled several days out and we have no control over the timing or location of your testing. We can only make a request for testing.
If you or your child has symptoms and requires a test, please assume at this time that they are very likely to have COVID-19 and it would be prudent to behave as such until testing is completed. Please stay home and away from others for fever, cough, congestion, sore throat, runny nose, headaches, body aches, chills, vomiting or diarrhea. Not only could any of these symptoms be COVID-19 but even if they are not, infecting others with other illnesses would then require them to find testing as well and this is a burden to the healthcare system at this time.
If your child's school requires return to school testing, please discuss with your school what their alternate plans are for children not able to secure testing this week. Unfortunately, this will not be a unique situation.
**If you have done a home test that is positive, and you or your child have symptoms or have been exposed, please consider this a positive test. No backup PCR testing is required. You are expected to follow the updated isolation guidance if you have a positive test. **
OFFICE VISITS: We have incredible numbers of patients who need to be seen and we expect this to be the case for the next several weeks. If your child has mild symptoms, please keep them home, plan for testing when it becomes available and monitor them closely. If your child is having any worrisome symptoms, such as difficulty breathing, signs of dehydration, overly irritable or overly lethargic, or other concerning symptoms, please call our office to plan a visit for your child. If they have minor symptoms and have fever that resolves in 3-4 days but are breathing comfortably, are hydrated and are acting reasonably well, especially when their temperature is down, then they can likely be monitored at home. If you are concerned about how your child is acting please call our office. If there are any acute concerns such as difficulty breathing or difficulty arousing your child or other more serious symptoms, please seek emergency care.
We had a limited supply of COVID-19 vaccine in our office. Currently we do not have vaccine available.
These vaccines are not supplied in the way we usually obtain our vaccines so the process is time consuming and has been challenging. We have been working hard to secure vaccines for our eligible patients. We are fielding very large numbers of calls and portal messages. We request that you please refer to the website and email blasts that we are sending out with updates for all information regarding the vaccines. We will post any updates on the website and will send additional emails as needed.
Yale opened four Pediatric vaccine sites in Greenwich, Bridgeport, New Haven and New London which will have wider availability than our office has at this time. Currently we do not have vaccine available in our office. We will update if/when we have that option for our patients.
If at all possible please refrain from calling the office or messaging your physician directly with vaccine scheduling questions and follow the directions on the website and in the email blasts that have been sent out. We are fielding unprecedented numbers of messages and calls to address vaccine and testing questions while we are seeing much higher than usual numbers of patients in the office. We appreciate your patience with us as we are trying to navigate these difficult times.
SCHEDULING COVID VACCINE APPOINTMENTS:
1. You may schedule at a Yale, Griffin or other hospital sites.
2. https://portal.ct.gov/Vaccine will link to available vaccine sites around the state.
3. Several pharmacies and hospitals are giving vaccines with scheduled visits and some allow walk-in appointments.
COVID EXPOSIRE/INFECTION UPDATES:
Information regarding COVID illnesses, isolation, quarantine and testing is listed below.
COVID-19 EXPOSURE/CONTACT GUIDANCE (Updated Dec 2021--please always check CDC guidance as well since information is changing rapidly)
We have been seeing increased numbers of positive COVID-19 cases in CT as well as in our CAHC office in the last several weeks. We encourage families to be thoughtful about gatherings, masking when in the company of others outside of your home and in public places. Any symptoms, even if mild, should prompt you to seek testing. The following is an update to help you to determine what exposures and contacts mean for you and your family members.
CONTACT= Being within 6 feet of someone for 15 minutes over a 24 hour period regardless of mask status. Or, direct close physical contact with a positive person, or their cough, spit, sneeze droplets
EXPOSURE= Contact (see above) with a person presumed positive or known positive for COVID-19 anytime from 2 days before their symptoms or positive test through the end of their 10 day isolation time.
ISOLATION=you are positive or presumed positive and are “isolating” away from others, including your own family members when possible and masking in home when you are in any shared space.
QUARANTINE=You have been exposed and are now staying HOME and away from others for a period of time until you have either had sufficient testing that you are negative or a determined period of time has passed from your LAST day of exposure to a positive person. Even if you come out of quarantine with new guidelines, you must monitor for any symptoms for the remainder of your period of "possibly infectious" time . (Please remember that if the person who exposed you can’t stay isolated from you then your quarantine will be longer because it is based on the LAST day you are in contact with the person who has covid…this may be the LAST day of their isolation period-- so the quarantine time would be those days plus the additional quarantine days after the positive case is done with their isolation period)
**(If you are immunocompromised your quarantine time may be up to 20 days, please contact your physician if this applies to you.)
EXPOSURE WHILE FULLY VACCINATED= (You are more than 2 weeks after your last dose of a 3 dose series of Pfizer or Moderna or 2 doses of J&J)
Get tested after exposure
You do not need to quarantine if you are feeling well
Wear a mask in public places for at least 10 days
Monitor for symptoms closely. ***Any symptoms require a test**** even if symptoms are mild (fatigue, headaches, scratchy throat, congestion)
Consider testing again around day 5
EXPOSURE WHILE UNVACCINATED OR NOT FULLY VACCINATED and ASYMPTOMATIC/NOT HAVING ANY SYMPTOMS:
1. Get tested when you are notified of exposure if possible but definitely at day 5 after exposure
2. Quarantine starts immediately for 5-10days depending on your school/employer policy. CDC does NOT include students and teachers in the newest "5 day plan" as of 12/29/21 https://www.cdc.gov/coronaviru...
3. You MUST monitor for symptoms for a full 10 days AND WEAR MASK in any public places for 10 days even if you are allowed to return on day 6 or 11 while masked.
4. GET TESTED AGAIN if you develop any symptoms whatsoever within the 10 day period
*IF YOU HAD COVID WITHIN 90 DAYS prior to the exposure you do not need to quarantine or get tested UNLESS YOU HAVE ANY SYMPTOMS. If you have any symptoms you do need to re-test and isolate until you have test results back.
WHILE YOU WAIT FOR TEST RESULTS:
-ANYONE WHO HAS TEST RESULTS PENDING WHO HAS HAD AN EXPOSURE SHOULD BE ISOLATING UNTIL THEIR TEST RESULT IS KNOWN.
-ANYONE WHO HAS A TEST RESULT PENDING WHO HAS ANY SYMPTOMS SHOULD ASSUME THEY HAVE COVID-19 UNTIL THEIR TEST RESULT IS BACK AND THEY SHOULD REMAIN HOME UNTIL THEY ARE FEELING BETTER IF THEIR TEST IS NEGATIVE.
A POSITIVE TEST:
At this time, given extremely high rates of COVID-19, ANY test that is positive is considered a positive test even if it is a home test or a rapid test. Repeating the test is not necessary and getting a "backup" test by PCR is not necessary either.
You must remain in isolation for 5-10 days from the beginning of symptoms or 5-10 days from the time of the test if you have no symptoms. (Depending on the policy of your school or employer) https://www.cdc.gov/coronaviru...
You may come out of isolation after 5-10 days depending on your work/school policy IF you have no fever for 24 hours and you are feeling well. If you are still not feeling well, extend your isolation period until you do. If you are eligible for early release from isolation (day 5 rather than day 10) PLEASE be mindful that this depends on your ability to remain properly masked at all times around others with a properly fit mask and you are feeling well without fever for 24 hours.
If you are immunosuppressed you will need to talk with your doctor about extending your isolation period up to 20 days or more.
***If you PLAY SPORTS please speak with your physician about when it would be safe to return to activity.
***If your child recovers and then gets sick again within 4-8 weeks after they had COVID-19 you need to contact us immediately if they have fever AND any of the following symptoms: abdominal pain, diarrhea, extreme fatigue, chest pain or tightness, bloodshot eyes, bad headache, neck pain, feeling faint or dizzy, rash, vomiting or are acting very ill or disoriented, or appear very pale or blue. Rarely, children can develop a condition called MIS-C after infection with COVID-19 and this can be very serious if not treated quickly. ****
A NEGATIVE TEST:
It is possible that your test was a false negative so please be thoughtful about when you are able to leave your quarantine as it is possible that you could still develop symptoms through day 10-14. Wear your mask for 10 days whenever in the presence of others.
Anyone who is sick should stay home until they are feeling better—NO fever for 24 hours off medication, eating and drinking well, having reasonable energy or for kids, not terribly fussy/back to their usual mood. Even if you do not have COVID-19, as anyone catching your illness would then have to go through all the testing, isolating, etc. to rule out covid if they become ill.
If your symptoms are suspiciously consistent with COVID-19 such as loss of smell/taste, pneumonia, etc. and you have had an exposure, please assume you have COVID-19 and isolate from others even if you have a negative test as there can be false negative test results.
Remember, if you have a negative test but were exposed, you need to wear a mask when around others for the full 10-14 days even if you are no longer in quarantine as you may become symptomatic later than 10 days and you may be contagious to others for up to 2 days prior to your symptoms starting.
A WORD ABOUT TESTING:
If your child has any symptoms please consider testing. Many cases have been asymptomatic or very mildly symptomatic and without testing we have no way of knowing. Any respiratory symptoms (congestion, runny nose, cough, sore throat, "allergy-like" symptoms, runny or bloodshot eyes, etc.) or gastrointestinal symptoms (vomiting/diarrhea/abdominal pain) can be associated with Covid-19. Fever, headache, body aches, chills, or fatigue have also been widely reported symptoms. Please test if there is any question.
If your child has any symptoms that are concerning for Covid-19 and you do not test, he/she must remain home for at least 10 days from the onset of symptoms before they can return to school, daycare, or be out in public spaces even if they are feeling well sooner than 10 days. He/She would be a presumed positive case and should follow all "isolation" guidelines listed above.
If you need testing related to travel or to enter an event and have no symptoms, the rapid antigen test is less reliable and we would encourage a PCR test if there are no associated symptoms. This is the testing that is done through the Yale New Haven testing sites.
Most children have done quite well with Covid-19 and if symptoms are mild, your child is acting fairly well, it would be ok to obtain testing without contacting our office first. Yale New Haven Hospital has a very efficient and convenient program for testing using the more reliable PCR test.
**Please note, results from Yale testing that were not ordered by our physicians do not automatically come to our office and you will need to access MyChart to access your results. Children over 15 will need their own MyChart login. Please let us know if your child tests positive so that we can talk through reasons that you would need to seek medical attention for your child and so that we can update your child's chart in our computer system.
At any time if your child has concerning symptoms (difficulty breathing, overly lethargic or overly irritable, is dehydrated, or anything else that has you worried) please call the office to schedule a visit but let us know that your child has Covid-19 so we can prepare appropriately for the visit. Also, another reminder that if your child has had covid and becomes sick again in the 4-8 weeks after they recover, you should be calling us for guidance as this can be a concern. If your child plays sports he/she will need clearance to return to sports if they had significant symptoms (fever over 3 days) and you should schedule a follow up visit with us 2-3 weeks after their illness.